Lp-PLA2、D-D、TG与早期冠状动脉粥样硬化形成相关性的Logistic回归分析  

Logistic regression analysis on correlation between Lp-PLA2,D-D and TG with early coronary atherosclerosis formation

作　　者：陈志城[1] 谢伟贤[1] 黄杰[1] 许莉莉 CHEN Zhicheng;XIE Weixian;HUNG Jie;XU Lili(Department of Clinical Laboratory,Foshan Municipal Second People′sHospital,Foshan,Guangdong 528000,China)

机构地区：[1]广东省佛山市第二人民医院检验科,528000

出　　处：《检验医学与临床》2019年第5期635-637,641,共4页Laboratory Medicine and Clinic

摘　　要：目的通过Logistic回归分析探讨血清脂蛋白相关磷脂酶A2(Lp-PLA2)、D-二聚体(D-D)和三酰甘油(TG)等因素与早期冠状动脉粥样硬化(CAS)形成的相关性。方法选取2017年6月至2018年6月该院心内科门诊疑似为CAS的患者287例,再根据诊断金标准冠状动脉造影做将疑似患者分为AS组(170例)和非AS组(117例)。采用相应的方法对Lp-PLA2、D-D以及TG进行测定,然后对差异有统计学意义的相关指标进行Logistic回归分析。结果单因素分析显示,AS组患者年龄、Lp-PLA2以及D-D的水平明显高于非AS组,差异均有统计学意义(P<0.05);Logistic回归分析显示,年龄和Lp-PLA2与CAS的形成呈正相关,偏回归系数分别为0.076、0.015,Wald值分别为33.213、20.871,P值均小于0.05。受试者工作特征曲线分析显示,LpPLA2的曲线下面积(AUC)为0.716,具有中等诊断效能,诊断特异度为82.1%,误诊率为17.9%,阴性预测值为60.4%,诊断灵敏度为62.9%,漏诊率为37.1%,阳性预测值为83.6%。结论年龄的增大以及血清Lp-PLA2高水平的表达是早期CAS形成的重要危险因素,随着年龄以及Lp-PLA2水平的升高,发生CAS的风险增大。Objective To investigate the correlation between serum lipoprotein associated phospholipase A2(Lp-PLA2),D-dimmer(D-D),triglyceride(TG)and other factors with early coronary atherosclerosis(CAS)formation by using the Logistic regression analysis.Methods A total of287 cases of suspected CAS in the cardiology department of this hospital from June2017 to June2018 were selected and divided into the AS group(n=170)and non-AS group(n=117)according to the diagnostic gold standard.The levels of Lp-PLA2,D-D and TG were tested by using the corresponding methods,and then the Logistic regression analysis was carried out on the related indicators with statistically significant difference.Results The single factor analysis showed that the levels of the age,Lp-PLA2 and the D-D in the AS group were significantly higher than those in the non-AS group,and the difference was statistically significant(P<0.05);the Logistic regression analysis showed that the age and Lp-PLA2 were positively correlated with the formation of CAS,the Partial regression coefficients were 0.076 and 0.015;the Wald values were 33.213 and20.871 respectively;P<0.05.The ROC curve analyze showed that the area under the curve(AUC)of Lp-PLA2 was 0.716,possessing the moderate diagnostic efficiency,the specificity of diagnosis was 82.1%,the misdiagnosis rate was 17.9%,the negative predictive value was 60.4%,the sensitivity of diagnosis was 62.9%,the missed diagnosis rate was 37.1%and the positive predictive value was 83.6%.Conclusion Age increase and high level expression of serum Lp-PLA2 are the important risk factors for early CAS formation,with the increase of age and Lp-PLA2 levels,the risk of CAS occurrence is increased.

关 键 词：冠状动脉粥样硬化 脂蛋白相关磷脂酶A2 D-二聚体 三酰甘油 

分 类 号：R446.1[医药卫生—诊断学]